A Compendium of Radiation Safety Practices That Can Complement Organizational Worker Well-being Initiatives.

ABSTRACT: Organizations are learning that efforts to protect the health and safety of their workers from risks both at work and outside of work yield great dividends in the form of increased productivity, morale, and reduced healthcare costs. This realization has given rise to a variety of worker well-being initiatives that span far beyond the typical boundaries of traditional workplace health and safety programs. Examples include providing information and services on diet, exercise, personal habits, and mental health issues. Interestingly, the radiation safety profession has been historically involved with a series of progressive worker well-being practices that perhaps are not fully appreciated by the broader well-being community. These include the ability to comprehensively track occupational doses, training regarding doses arising from outside the workplace (such as medical procedures and environmental exposures), and fetal protection policies, to name a few. Described here is the shift in perspective from health and safety merely for the workplace to a more holistic approach, but the degree to which the actions may be implemented varies. Included then is a compendium of radiation safety practices that may be possibly folded into the discussion of larger organizational well-being efforts.

The Role of Participation in and Effectiveness of Shared Governance Councils in the Nurses' Perception of a Professional Practice Work Environment.

OBJECTIVES: The aims of this study were to identify the differences in nurses' perceptions of their professional practice work environment (PPWE) related to their participation in shared governance (SG) councils and to examine the perception of effectiveness of SG councils among nurses who participate in them. BACKGROUND: Research suggests that adopting SG in nursing can lead to significant, positive outcomes, such as patient and nurse satisfaction and enhanced nurse empowerment, engagement, and a PPWE. METHODS: The study used a cross-sectional design in a Magnet®-designated urban Jordanian cancer care hospital. A convenience sample of 580 direct care nurses was used. The data were collected using self-administered questionnaires, the Council Health (CH) instrument, and the Professional Practice Work Environment Inventory (PPWEI). RESULTS: Results demonstrated a significant difference in the total score of PPWE between the SG council members (4.85) and nonmembers (4.68) (t = 2.906, P = 0.004). The results also indicated small to strong correlations of the total overall council health mean and all domain means of council effectiveness with total overall PPWEI mean and all domain means of PPWE (P < 0.05) among nurses who participated in SG councils. CONCLUSION: Findings support involving more staff in SG councils and that enhancing the SG councils' effectiveness positively affects the PPWE.

Association of occupational sun safety policy and actions in state transportation sector in the United States.

BACKGROUND: Occupational sun protection is recommended by government health authorities. Sun safety policies and predictors of managers' reports of sun safety actions were assessed. METHODS: Written policies from 21 state departments of transportation (DOTs) enrolled in a randomized trial to test methods for scaling-up an occupational sun safety intervention were coded for sun safety content at baseline. Managers (n = 1113) supervising outdoor workers reported on sun safety actions in a baseline survey. RESULTS: Twenty state DOTs (95.2%) have a policy with at least one sun protection component. Sun safety training was increased at workplaces with a written sun safety policy (p < 0.001) and unwritten standard procedures on sun protection (p < 0.001). Reported sun safety actions were highest where there was a written sun safety policy (p < 0.001) and unwritten standard procedures on sun protection (p < 0.001). CONCLUSIONS: Policies are essential for the implementation of employee sun safety. There is room for improvement in existing policies of state DOTs.

Changes in risk factors for non-communicable diseases associated with the 'Healthy choices at work' programme, South Africa.

BACKGROUND: Globally 71% of deaths are attributed to non-communicable diseases (NCD). The workplace is an opportune setting for health promotion programs and interventions that aim to prevent NCDs. However, much of the current evidence is from high-income countries. OBJECTIVE: The aim of this study was to evaluate changes in NCD risk factors, associated with the Healthy Choices at Work programme (HCWP), at a commercial power plant in South Africa. METHODS: This was a before-and-after study in a randomly selected sample of 156 employees at baseline and 137 employees at 2-years. The HCWP focused on food services, physical activity, health and wellness services and managerial support. Participants completed questionnaires on tobacco smoking, harmful alcohol use, fruit and vegetable intake, physical activity, psychosocial stress and history of NCDs. Clinical measures included blood pressure, total cholesterol, random blood glucose, body mass index, waist circumference and waist-to-hip ratio. The 10-year cardiovascular risk was calculated using a validated algorithm. Sample size calculations evaluated the power of the sample to detect meaningful changes in risk factors. RESULTS: Paired data was obtained for 137 employees, the mean age was 42.7 years (SD 9.7) and 64% were male. The prevalence of sufficient fruit and vegetable intake increased from 27% to 64% (p < 0.001), those meeting physical activity guidelines increased from 44% to 65% (p < 0.001). Harmful alcohol use decreased from 21% to 5% (p = 0.001). There were clinical and statistically significant improvements in systolic and diastolic blood pressure (mean difference -10.2 mmHg (95%CI: -7.3 to -13.2); and -3.9 mmHg (95%CI: -1.8 to -5.8); p < 0.001) and total cholesterol (mean difference -0.45 mmol/l (-0.3 to -0.6)). There were no significant improvements in BMI. Psychosocial stress from relationships with colleagues, personal finances, and personal health improved significantly. The cardiovascular risk score decreased by 4.5% (> 0.05). CONCLUSION: The HCWP was associated with clinically significant reductions in behavioural, metabolic and psychosocial risk factors for NCDs.

Health Promotion Programs and Policies in the Workplace: An Exploratory Study With Alaska Businesses.

INTRODUCTION: We examined health insurance benefits, workplace policies, and health promotion programs in small to midsize businesses in Alaska whose workforces were at least 20% Alaska Native. Participating businesses were enrolled in a randomized trial to improve health promotion efforts. METHODS: Twenty-six Alaska businesses completed from January 2009 through October 2010 a 30-item survey on health benefits, policies, and programs in the workplace. We generated frequency statistics to describe overall insurance coverage, and to detail insurance coverage, company policies, and workplace programs in 3 domains: tobacco use, physical activity and nutrition, and disease screening and management. RESULTS: Businesses varied in the number of employees (mean, 250; median, 121; range, 41-1,200). Most businesses offered at least partial health insurance for full-time employees and their dependents. Businesses completely banned tobacco in the workplace, and insurance coverage for tobacco cessation was limited. Eighteen had onsite food vendors, yet fewer than 6 businesses offered healthy food options, and even fewer offered them at competitive prices. Cancer screening and treatment were the health benefits most commonly covered by insurance. CONCLUSION: Although insurance coverage and workplace policies for chronic disease screening and management were widely available, significant opportunities remain for Alaska businesses to collaborate with federal, state, and community organizations on health promotion efforts to reduce the risk of chronic illness among their employees.

A review of studies on the COVID-19 epidemic crisis disease with a preventive approach.

BACKGROUND: COVID-19 is a highly contagious acute respiratory syndrome and has been declared a pandemic in more than 209 countries worldwide. At the time of writing, no preventive vaccine has been developed and tested in the community. This study was conducted to review studies aimed at preventing the spread of the coronavirus worldwide. METHODS: This study was a review of the evidence-based literature and was conducted by searching databases, including Google Scholar, PubMed, and ScienceDirect, until April 2020. The search was performed based on keywords including "coronavirus", "COVID-19", and "prevention". The list of references in the final studies has also been re-reviewed to find articles that might not have been obtained through the search. The guidelines published by trustworthy organizations such as the World Health Organization and Center for Disease Control have been used in this study. CONCLUSION: So far, no vaccine or definitive treatment for COVID-19 has been invented, and the disease has become a pandemic. Therefore, observation of hand hygiene, disinfection of high-touch surfaces, observation of social distance, and lack of presence in public places are recommended as preventive measures. Moreover, to control the situation and to reduce the incidence of the virus, some of the measures taken by the decision-making bodies and the guidelines of the deterrent institutions to strengthen telecommuting of employees and reduce the presence of people in the community and prevent unnecessary activities, are very important.

Effects of workplaces receiving "accreditation of health workplaces" on breastfeeding promotion, parental leave, and gender equality.

OBJECTIVES: Work is often a barrier for women to continue breastfeeding after they have given birth. Breastfeeding support is an important part of workplace health promotion. We investigated the implementation of breastfeeding promotion and gender equality polices in workplaces with the Taiwan Badge of Accredited Healthy Workplace. METHODS: Our samples consisted of 1648 corporations with the badge of Accredited Healthy Workplace issued by the Bureau of Health Promotion from 2007 to 2008. Concomitantly, 2000 corporations without accreditation were randomly selected from the National Business Directory as the control group. Data were collected from self-administered questionnaires. Logistic regression was used to examine the association with breast-feeding promotion and other variables in Taiwanese workplaces. RESULTS: Members of accredited group of 1089/1648 (66.1%) and the control group of 526/2000 (26.3%) responded to the questionnaire. The accredited companies had more mother-friendly settings, including breastfeeding policies and documents, appropriate breastmilk preserving equipment and settings in the workplace. In the accredited group, breastfeeding rate of mothers returning to work after giving birth was 64.3% in 2008 (1 year after giving birth) and 60.4% in 2009 (1 year after giving birth), while the rate of the control group was 59.1% in 2008 and 51% in 2009. CONCLUSION: Accredited corporations are better at breastfeeding support than those of the control group. This might be related to the company size, location, and the implementation of tobacco control and/or occupational health promotion policies, which may increase awareness of healthy workplaces and influence maternal protection positively.

Optimizing the Cognitive Space of Nursing Work Through Electronic Medical Records.

The incorporation of electronic medical records into nursing practice highlights the need to facilitate communication among nurses. The extensive use of information suggests that electronic medical records should be considered in the cognitive workspace to manage information and facilitate communication. The purpose of this study was to construct an integrative model to explain the role of electronic medical records in the cognitive workspace. This work is grounded in the Theory of Swift and Even Flow and Distributive Cognition. The Distributive Cognitive model views the workplace as a cognitive system, such that cognitive processes do not occur in individual clinicians, but as a collaborative effort among nurses. The Theory of Swift and Even Flow was used to explain the flow of information among nurses. We used a qualitative approach to gather data from nurses at local inpatient facilities. Seven focus groups among three facilities were completed (n = 34). A semistructured questionnaire guided the focus group sessions. The results suggest that electronic medical records contribute to the cognitive workspace by serving as a conduit for information to be collected and distributed. These systems may positively influence nursing care when the quality, quantity, and timeliness of information are optimized.

Barriers and bridges to implementing a workplace wellness project in Alaska.

CONTEXT: The vast, rugged geography and dispersed population of Alaska pose challenges for managing chronic disease risk. Creative, population-based approaches are essential to address the region's health needs. The American Cancer Society developed Workplace Solutions, a series of evidence-based interventions, to improve health promotion and reduce chronic disease risk in workplace settings. ISSUES: To adapt Workplace Solutions for implementation in eligible Alaskan businesses, research teams with the University of Washington and the Alaska Native Tribal Health Consortium collaborated to address various geographic, intervention, and workplace barriers. Terrain, weather, and hunting seasons were frequent geographic challenges faced over the entire course of the pilot study. Coordinating several research review boards at the university, workplace, and regional tribal health organizations; study staff turnover during the entire course of the study; and difficulties obtaining cost-effective intervention options were common intervention barriers. Few workplaces meeting initial study eligibility criteria, turnover of business contacts, and a downturn in the state economy were all significant workplace barriers. LESSONS LEARNED: Flexibility, organization, responsiveness, communication, and collaboration between research staff and businesses were routinely required to problem-solve these geographic, intervention, and workplace barriers.

Barriers to surgery performed by non-physician clinicians in sub-Saharan Africa-a scoping review.

BACKGROUND: Sub-Saharan Africa (SSA) faces the highest burden of disease amenable to surgery while having the lowest surgeon to population ratio in the world. Some 25 SSA countries use surgical task-shifting from physicians to non-physician clinicians (NPCs) as a strategy to increase access to surgery. While many studies have investigated barriers to access to surgical services, there is a dearth of studies that examine the barriers to shifting of surgical tasks to, and the delivery of safe essential surgical care by NPCs, especially in rural areas of SSA. This study aims to identify those barriers and how they vary between surgical disciplines as well as between countries. METHODS: We performed a scoping review of articles published between 2000 and 2018, listed in PubMed or Embase. Full-text articles were read by two reviewers to identify barriers to surgical task-shifting. Cited barriers were counted and categorized, partly based on the World Health Organization (WHO) health systems building blocks. RESULTS: Sixty-two articles met the inclusion criteria, and 14 clusters of barriers were identified, which were assigned to four main categories: primary outcomes, NPC workforce, regulation, and environment and resources. Malawi, Tanzania, Uganda, and Mozambique had the largest number of articles reporting barriers, with Uganda reporting the largest variety of barriers from empirical studies only. Obstetric and gynaecologic surgery had more articles and cited barriers than other specialties. CONCLUSION: A multitude of factors hampers the provision of surgery by NPCs across SSA. The two main issues are surgical pre-requisites and the need for regulatory and professional frameworks to legitimate and control the surgical practice of NPCs.

Between a rock and a hard place: Registered nurses' accounts of their work situation in cancer care in Swedish acute care hospitals.

PURPOSE: Hospital organizational features related to registered nurses' (RNs') practice environment are often studied using quantitative measures. These are however unable to capture nuances of experiences of the practice environment from the perspective of individual RNs. The aim of this study is therefore to investigate individual RNs' experiences of their work situation in cancer care in Swedish acute care hospitals. METHODS: This study is based on a qualitative framework analysis of data derived from an open-ended question by 200 RNs working in specialized or general cancer care hospital units, who responded to the Swedish RN4CAST survey on nurse work environment. Antonovsky's salutogenic concepts "meaningfulness", "comprehensibility", and "manageability" were applied post-analysis to support interpretation of results. RESULTS: RNs describe a tension between expectations to uphold safe, high quality care, and working in an environment where they are unable to influence conditions for care delivery. A lacking sense of agency, on individual and collective levels, points to organizational factors impeding RNs' use of their competence in clinical decision-making and in governing practice within their professional scope. CONCLUSIONS: RNs in this study appear to experience work situations which, while often described as meaningful, generally appear neither comprehensible nor manageable. The lack of an individual and collective sense of agency found here could potentially erode RNs' sense of meaningfulness and readiness to invest in their work.

Measuring social capital of healthcare organizations reported by employees for creating positive workplaces - validation of the SOCAPO-E instrument.

BACKGROUND: In highly segmented and complex healthcare organizations social capital is assumed to be of high relevance for the coordination of tasks in healthcare. So far, comprehensively validated instruments on social capital in healthcare organizations are lacking. The aim of this work is to validate an instrument measuring social capital in healthcare organizations. METHODS: This validation study is based on a cross-sectional survey of 1050 hospital employees from 49 German hospitals which specialize in breast cancer care. Social capital was assessed by a six-item scale. Reliability analyses and confirmatory factor analyses were conducted to determine the content validity of items within the theory-driven one-dimensional scale structure. The scale's associations with measures of the social aspects of the work environment (identification, social support, open communication climate) were estimated to test convergent validity. Criterion-related validity was evaluated by conducting structural equation modelling to examine the predictive validity of the scale with measures of work engagement, well-being and burnout. RESULTS: A one-dimensional structure of the instrument could be identified (CFI = .99; RMSEA = .06). Convergent validity was shown by hypothesis-consistent correlations with social support offered by supervisors and colleagues, a climate of open communication, and employee commitment to the organization. Criterion-related validity of the social capital scale was proved by its prediction of employee work engagement (R2 = .10-.13 for the three subscales), well-being (R2 = .13), and burnout (R2 = .06-.11 for the three subscales). CONCLUSIONS: The confirmed associations between social capital and work engagement, burnout as well as well-being stress the importance of social capital as a vital resource for employee health and performance in healthcare organizations. In healthcare organizations this short instrument can be used as an efficient instrument to measure the organizations' social capital.

Nota informativa nº 05 /2020-GST/DVAST/SVS/SES: recomendações aos gestores e profissionais da segurança pública para enfrentamento da pandemia de Coronavírus ­ COVID-19 (infecção pelo SARS-CoV-2) / Informative note nº 05/2020-GST / DVAST / SVS / SES: recommendations to managers and public security professionals to cope with the Coronavirus pandemic - COVID-19 (SARS-CoV-2 infection)

Recomendações aos gestores e trabalhadores da Segurança pública (policiais federais, rodoviários, militares, civis, municipais, bombeiros, agentes penitenciários e socioeducativos) para discussão coletiva sobre medidas que amenizem os riscos à saúde dos trabalhadores e pessoas privadas de liberdade, como também, reduzam a disseminação do COVID-19 para seus familiares e a população em geral.

Recommendations to the managers and workers of public security (police federais, rodoviários, military, civis, municipais, bombeiros, penitentiary and socio-educational agents) for collective discussion on measures that mitigate the risks to the health of two workers and people deprived of freedom, as also, also, a dissemination of COVID-19 for family members and general population.

Recomendaciones a los gerentes y trabajadores de seguridad pública (federal, vial, militar, civil, municipal, bomberos, agentes penitenciarios y socioeducativos) para la discusión colectiva sobre medidas para mitigar los riesgos para la salud de los trabajadores y personas privadas de libertad, así como reducir la difusión del COVID-19 a sus familias y población en general.

Condiciones de trabajo, seguridad y salud en la población económicamente activa y ocupada en áreas urbanas del Perú / Working, safety and health conditions in the economically active and employed population in urban areas of Peru

RESUMEN Objetivos: La presente investigación tiene como objetivo conocer las condiciones de trabajo, seguridad y sa lud en el trabajo de la población urbana económicamente activa ocupada del Perú. Materiales y métodos: Se realizó un estudio transversal basado en una muestra probabilística de áreas y multietápica en la que partici paron 3122 personas mayores de 14 años distribuidas en todo el país. Resultados : La mayoría fueron hombres (53,6%) entre 30 y 59 años (50%). En cuanto a las condiciones de trabajo, la mayoría labora más de 48 horas semanales (39,8%) y de lunes a sábado (44,7%). Respecto a las condiciones de seguridad, higiene, ergonómicas y psicosociales, los resultados mostraron una menor exposición de riesgo. Sobre las condiciones de salud, la mayoría refiere que no se identifican ni se evalúan los riesgos laborales en su puesto de trabajo (35,9%); que no tienen servicios de salud ocupacional (40,7%) ni un delegado o un comité de seguridad y salud (39,4%); y que no se le realizan evaluaciones médico ocupacionales (39,3%). Conclusiones: La población económica mente activa urbana ocupada del Perú se expone con más frecuencia al ruido, la radiación solar, las posturas incómodas y los movimientos repetitivos; trabaja rápido con poco control y esconde sus emociones; además, en los lugares de trabajo no se gestiona la salud ocupacional. Estas condiciones pueden afectar la salud de los trabajadores y la calidad del trabajo.

ABSTRACT Objetives: The present study aims to know the work, safety and health conditions at the jobs of the economically active urban population in Peru. Materials and Methods: A cross-sectional study was carried out based on a probabilistic sample of multistage areas in which 3122 people over 14 years of age distributed nationwide partici pated. Results: The majority were men (53.6%) between 30 and 59 years (50%). As for working conditions, most people work more than 48 hours per week (39.8%), and Monday through Saturday (44.7%). Regarding the safety, hygiene, ergonomic and psychosocial conditions, the results showed a lower risk exposure. Regarding health conditions, the majority report that the identification and evaluation of occupational hazards is not carried out in their workplace (35.9%), they do not have occupational health services (40.7%) or a delegate or a Health and sa fety committee (39.4%) and no occupational medical evaluations (39.3%). Conclusions: The economically active urban population of Peru is more frequently exposed to noise, solar radiation, awkward postures and repetitive movements, work at a fast pace with little control and hide their emotions; In addition, occupational health is not managed adequately in workplaces. These conditions may affect the health of workers and the quality of work.

[Pathologist occupational hazards: Results of a survey for the French case]. / Risques professionnels chez les pathologistes : résultats d'une enquête française.

INTRODUCTION: The profession of pathologist exposes to various risks, notably infectious, physical and chemical. The objective of this study was to make an inventory of these occupational risks to which pathologists are subjected and to evaluate the pathologies that they presented. A particular attention was given to microscopic and screen work as they can induce musculoskeletal or ophthalmic disorders, and stress-related psychological disorders. METHOD: An anonymous online questionnaire containing 54 questions had been sent by mail to pathologists via the French Society of Pathology and the Syndicate of French Pathologists. RESULTS: Five hundred and twelve pathologists responded to the survey. Thirty-eight percent reported musculoskeletal disorders in the last 6 months. Visual disturbances concerned 73.4% of respondents. In the last 12 months, 33.3% of pathologists had been injured or had had mucosal projections during macroscopic or autopsy specimens. The frequency of infectious diseases was low (6.2%) as well as that of cancers (3.9%). Psychological disorders such as depression or burnout were reported by 16.7% of respondents. Pathologists seemed happy at work and had a good overall lifestyle. Few doctors had medical follow-up and few had benefited from ergonomic advice and training on the risks of chemicals. CONCLUSION: The results of this study showed the interest of a medical surveillance adapted to the pathologies presented by the pathologists. Educational and preventive measures should be introduced early in the career, focusing on ergonomics and learning about chemical and biological hazards.

Trends in admission timing and mechanism of injury can be used to improve general surgical trauma training.

INTRODUCTION: The temporal patterns and unit-based distributions of trauma patients requiring surgical intervention are poorly described in the UK. We describe the distribution of trauma patients in the UK and assess whether changes in working patterns could provide greater exposure for operative trauma training. METHODS: We searched the Trauma Audit and Research Network database to identify all patients between 1 January 2014 to 31 December 2016. Operative cases were defined as all patients who underwent laparotomy, thoracotomy or open vascular intervention. We assessed time of arrival, correlations between mechanism of injury and surgery, and the effect of changing shift patterns on exposure to trauma patients by reference to a standard 10-hour shift assuming a dedicated trauma rotation or fellowship. RESULTS: There were 159,719 patients from 194 hospitals submitted to the Network between 2014 and 2016. The busiest 20 centres accounted for 57,568 (36.0%) of cases in total. Of these 2147/57,568 patients (3.7%) required a general surgical operation; 43% of penetrating admissions (925 cases) and 2.2% of blunt admissions (1222 cases). The number of operations correlated more closely with the number of penetrating rather than blunt admissions (r = 0.89 vs r = 0.51). A diurnal pattern in trauma admissions enabled significant increases in trauma exposure with later start times. CONCLUSIONS: Centres with high volume and high penetrating rates are likely to require more general surgical input and should be identified as locations for operative trauma training. It is possible to improve the number of trauma patients seen in a shift by optimising shift start time.

Self-efficacy and Physical Activity in Overweight and Obese Adults Participating in a Worksite Weight Loss Intervention: Multistate Modeling of Wearable Device Data.

BACKGROUND: Physical activity is associated with a reduced risk of numerous types of cancer and plays an important role in maintaining a healthy weight. Wearable physical activity trackers may supplement behavioral intervention and enable researchers to study how determinants like self-efficacy predict physical activity patterns over time. METHODS: We used multistate models to evaluate how self-efficacy predicted physical activity states among overweight and obese individuals participating in a 26-week weight loss program (N = 96). We specified five states to capture physical activity patterns: (i) active (i.e., meeting recommendations for 2 weeks), (ii) insufficiently active, (iii) nonvalid wear, (iv) favorable transition (i.e., improvement in physical activity over 2 weeks), and (v) unfavorable transition. We calculated HRs of transition probabilities by self-efficacy, body mass index, age, and time. RESULTS: The average prevalence of individuals in the active, insufficiently active, and nonvalid wear states was 13%, 44%, and 16%, respectively. Low self-efficacy negatively predicted entering an active state [HR, 0.51; 95% confidence interval (CI), 0.29-0.88]. Obesity negatively predicted making a favorable transition out of an insufficiently active state (HR, 0.61; 95% CI, 0.40-0.91). Older participants were less likely to transition to the nonvalid wear state (HR, 0.53; 95% CI, 0.30-0.93). Device nonwear increased in the second half of the intervention (HR, 1.73; 95% CI, 1.07-2.81). CONCLUSIONS: Self-efficacy is an important predictor for clinically relevant physical activity change in overweight and obese individuals. Multistate modeling is useful for analyzing longitudinal physical activity data. IMPACT: Multistate modeling can be used for statistical inference of covariates and allow for explicit modeling of nonvalid wear.See all articles in this CEBP Focus section, "Modernizing Population Science."